Communication between patients, peers, and care providers through a mobile health intervention supporting medication-assisted treatment for opioid use disorder

Are Treatment Services Ready for the Use of Big Data Analytics and AI in Managing Opioid Use Disorder?

In this viewpoint, we explore the use of big data analytics and artificial intelligence (AI) and discuss important challenges to their ethical, effective, and equitable use within opioid use disorder (OUD) treatment settings. Applying our collective experiences as OUD policy and treatment experts, we discuss 8 key challenges that OUD treatment services must contend with to make the most of these rapidly evolving technologies: data and algorithmic transparency, clinical validation, new practitioner-technology interfaces, capturing data relevant to improving patient care, understanding and responding to algorithmic outputs, obtaining informed patient consent, navigating mistrust, and addressing digital exclusion and bias. Through this paper, we hope to critically engage clinicians and policy makers on important ethical considerations, clinical implications, and implementation challenges involved in big data analytics and AI deployment in OUD treatment settings.

To adopt or not to adopt mobile health applications? A study among Generation X mobile phone users in a developing country

PURPOSE

This study utilizes the extended technology acceptance model (E-TAM) to explore the key factors influencing the behavioral intention of Generation X (Gen X) users in Malaysia to adopt mobile health applications (MHAs).

DESIGN/METHODOLOGY/APPROACH

A total of 252 responses were gathered from the Malaysian Gen X population through an online survey using a non-probability purposive sampling technique. Data were analyzed using SmartPLS software to validate the proposed framework and provide a logical foundation for achieving the study's objectives.

FINDINGS

The results reveal that perceived system quality (PSQ), perceived mobile experience (PXS), perceived ease of use (PEOU), perceived playfulness (PPF), perceived usefulness (PU) and attitude are all positively associated with behavioral intention to use MHAs.

ORIGINALITY/VALUE

This research extends the TAM by introducing novel constructs - PSQ, PXS and PPF - forming the E-TAM framework to analyze MHA adoption, a perspective not previously explored in the Malaysian context. From a practical standpoint, this study provides actionable insights to enhance the adoption of MHAs among Malaysia's pivotal Gen X population. The findings aim to guide the development of engaging and user-friendly mHealth applications to improve self-care capabilities and increase user satisfaction.

Leveraging Trauma Informed Care for Digital Health Intervention Development in Opioid Use Disorder

Digital health refers to the use of information and communication technologies in medicine (including smartphone apps, wearables, other non-invasive sensors, informatics and telehealth platforms) to prevent illness, deliver treatment, and promote wellness. This rapidly proliferating group of technologies has the potential to reduce harm for people with opioid use disorder (OUD) and facilitate the recovery process; however, development in this space for OUD has been slower compared to that for other medical conditions. Unique issues with OUD management surrounding patient provider relationships, interaction with the healthcare system, autonomy and trust sometimes hinder care approaches, including those in digital health. The trauma informed care framework (TIC), developed for use by organizations to support individuals who have experienced trauma, has particular applicability for digital health interventions in OUD care. This manuscript will serve as a review of TIC principles and how they can be applied to digital health interventions to increase access, equity, and empowerment for people with OUD. We will highlight representative current and pipeline digital technologies for OUD, challenges with these technologies, TIC models for OUD, and the integration of TIC principles into digital technology development to better serve people with OUD. Finally, we will posit strategies to incorporate the aforementioned principles into future research efforts. We ultimately aim to use TIC as a lens through which to develop digital technologies to help individuals with OUD while minimizing harm.

Evaluation of a Pilot Program to Prevent the Misuse of Prescribed Opioids Among Health Care Workers: Repeated Measures Survey Study

BACKGROUND

Overprescription of opioids has led to increased misuse of opioids, resulting in higher rates of overdose. The workplace can play a vital role in an individual's intentions to misuse prescription opioids with injured workers being prescribed opioids, at a rate 3 times the national average. For example, health care workers are at risk for injuries, opioid dispensing, and diversion. Intervening within a context that may contribute to risks for opioid misuse while targeting individual psychosocial factors may be a useful complement to interventions at policy and prescribing levels.

OBJECTIVE

This pilot study assessed the effects of a mobile-friendly opioid misuse intervention prototype tailored for health care workers using the preparation phase of a multiphase optimization strategy design.

METHODS

A total of 33 health care practitioners participated in the pilot intervention, which included 10 brief web-based lessons aimed at impacting psychosocial measures that underlie opioid misuse. The lesson topics included: addiction beliefs, addiction control, Centers for Disease Control and Prevention guidelines and recommendations, beliefs about patient-provider relationships and communication, control in communicating with providers, beliefs about self-monitoring pain and side effects, control in self-monitoring pain and side effects, diversion and disposal beliefs, diversion and disposal control, and a conclusion lesson. Using a treatment-only design, pretest and posttest surveys were collected. A general linear repeated measures ANOVA was used to assess mean differences from pretest to posttest. Descriptive statistics were used to assess participant feedback about the intervention.

RESULTS

After completing the intervention, participants showed significant mean changes with increases in knowledge of opioids (+0.459; P<.001), less favorable attitudes toward opioids (-1.081; P=.001), more positive beliefs about communication with providers (+0.205; P=.01), more positive beliefs about pain management control (+0.969; P<.001), and increased intentions to avoid opioid use (+0.212; P=.03). Of the 33 practitioners who completed the program, most felt positive about the information presented, and almost 70% (23/33) agreed or strongly agreed that other workers in the industry should complete a program like this.

CONCLUSIONS

While attempts to address the opioid crisis have been made through public health policies and prescribing initiatives, opioid misuse continues to rise. Certain industries place workers at greater risk for injury and opioid dispensing, making interventions that target workers in these industries of particular importance. Results from this pilot study show positive impacts on knowledge, attitudes, and beliefs about communicating with providers and pain management control, as well as intentions to avoid opioid misuse. However, the dropout rate and small sample size are severe limitations, and the results lack generalizability. Results will be used to inform program revisions and future optimization trials, with the intention of providing insight for future intervention development and evaluation of mobile-friendly eHealth interventions for employees.

Users' Acceptability and Perceived Efficacy of mHealth for Opioid Use Disorder: Scoping Review

BACKGROUND

The opioid crisis continues to pose significant challenges to global public health, necessitating the development of novel interventions to support individuals in managing their substance use and preventing overdose-related deaths. Mobile health (mHealth), as a promising platform for addressing opioid use disorder, requires a comprehensive understanding of user perspectives to minimize barriers to care and optimize the benefits of mHealth interventions.

OBJECTIVE

This study aims to synthesize qualitative insights into opioid users' acceptability and perceived efficacy of mHealth and wearable technologies for opioid use disorder.

METHODS

A scoping review of PubMed (MEDLINE) and Google Scholar databases was conducted to identify research on opioid user perspectives concerning mHealth-assisted interventions, including wearable sensors, SMS text messaging, and app-based technology.

RESULTS

Overall, users demonstrate a high willingness to engage with mHealth interventions to prevent overdose-related deaths and manage opioid use. Users perceive mHealth as an opportunity to access care and desire the involvement of trusted health care professionals in these technologies. User comfort with wearing opioid sensors emerged as a significant factor. Personally tailored content, social support, and encouragement are preferred by users. Privacy concerns and limited access to technology pose barriers to care.

CONCLUSIONS

To maximize benefits and minimize risks for users, it is crucial to implement robust privacy measures, provide comprehensive user training, integrate behavior change techniques, offer professional and peer support, deliver tailored messages, incorporate behavior change theories, assess readiness for change, design stigma-reducing apps, use visual elements, and conduct user-focused research for effective opioid management in mHealth interventions. mHealth demonstrates considerable potential as a tool for addressing opioid use disorder and preventing overdose-related deaths, given the high acceptability and perceived benefits reported by users.

Mobile care app development process: using the ADDIE model to manage symptoms after breast cancer surgery (step 1)

The use of mobile applications is widespread in patient monitoring or education today. This study aims to describe the design and development process of a mobile app that supports patient self-care after breast cancer surgery. We used the ADDIE model to develop and test the mobile app. ADDIE (Analysis, Design, Development, Implementation, Evaluation) is a systematic approach based on a standard instructional design model for creating training materials. The model consists of five phases, each with its own set of steps. Once the steps within each phase are completed, the model progresses to the next phase, ultimately resulting in a "usable" product. Different team collaborations were established within each phase, and support was obtained from multiple experts during the design process. Thanks to this model, the information that patients need was transformed into a technological product. This article, which explains the stages of the product design process for mobile applications, provides information that may be helpful to researchers working on similar products.

Art Advocacy: Applying a Public Memory Rhetorical Framework to Health Crisis Communication

Health campaigns and public health messaging strategies often rely on text-based efforts to communicate with audiences. As research grows in the areas of health and visual media, this essay puts a rhetorical framework of public memory in conversation with health campaign communication to show possibilities for audiences who are less likely to be moved by traditional institutional health narratives. The artifact for analysis is an art installation by Domenic Esposito, who in 2018 designed and placed a large scale "Opioid Spoon" at the headquarters of Purdue Pharma in Stamford, Connecticut. After situating public art as an effective way to advance health crisis messaging, we then preview the next phase of this research project that analyzes COVID-19 art as a counterpublic health narrative. We conclude by suggesting future health communication scholarship engage with the intersections of public health art, memory, and advocacy in order to reflect more accurately how communities experience health inequity.

Telehealth-Based Delivery of Medication-Assisted Treatment for Opioid Use Disorder: a Critical Review of Recent Developments

PURPOSE OF REVIEW

Telehealth-delivered medication-assisted treatment for opioid use disorder (tele-MOUD) has received increased attention, with the intersection of the opioid epidemic and COVID-19 pandemic, but research on recent developments is scattered. We critically review recent literature on tele-MOUD and synthesize studies reporting primary data under four themes: clinical effectiveness, non-clinical effectiveness, perceptions, and regulatory considerations.

RECENT FINDINGS

Despite increasing publications, most failed to include long-term comprehensive assessments. Findings indicate favorable outcomes such as improvements in retention and abstinence rates, positive experiences, and improved feasibility with the relaxation of regulatory measures. With increased adoption, clinician and patient perceptions appeared largely positive. Negative findings, albeit minor, were primarily associated with workflow adaptation difficulties and limited access of underserved populations to technology and internet connection. Additional financial, logistical, outreach, and training support for clinicians, patients, and support staff is recommended, in addition to permanent evidence-based regulatory reforms, to scale and optimize tele-MOUD services. Comprehensive recommendations to overcome limitations are expanded therein.